Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $80.45 / $80.45	Facility		$80.45	$80.45	$80.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.44 / $80.45 / $134.06	Professional		$66.44	$80.45	$134.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $159.47 / $175.43 / $290.25	Facility		$159.47	$175.43	$290.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $148.32 / $196.16	Professional		$137.93	$148.32	$196.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.73 / $341.29 / $341.29	Facility		$114.73	$341.29	$341.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.66 / $329.25 / $666.19	Facility		$99.66	$329.25	$666.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.75 / $231.09 / $301.83	Professional		$72.75	$231.09	$301.83
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.37 / $120.68 / $183.40	Facility		$51.37	$120.68	$183.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $91.32 / $159.47 / $212.64	Professional		$91.32	$159.47	$212.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $159.47 / $840.48	Facility		$80.45	$159.47	$840.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.15 / $106.56 / $180.05	Professional		$74.15	$106.56	$180.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $107.63	Professional		$50.00	$65.00	$107.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.37 / $123.09 / $183.40	Facility		$51.37	$123.09	$183.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $91.32 / $159.47 / $212.64	Professional		$91.32	$159.47	$212.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $245.44 / $477.76	Professional		$159.47	$245.44	$477.76
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.66 / $311.50 / $840.48	Facility		$99.66	$311.50	$840.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.75 / $99.66 / $1,182.74	Professional		$72.75	$99.66	$1,182.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $159.47 / $159.47	Professional		$159.47	$159.47	$159.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $159.47 / $159.47 / $159.47	Professional		$159.47	$159.47	$159.47
United Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $105.14 / $141.40	Professional		$63.54	$105.14	$141.40